Traditional Chinese Medicine related factors of planned dialysis in chronic kidney disease stage 5 patients with type 2 diabetes mellitus: a multicenter cross-sectional study.

OBJECTIVE: To clarify the distribution of Traditional Chinese Medicine (TCM) symptoms, syndrome elements and complications in chronic kidney disease stage 5 (CKD5) patients with type 2 diabetes mellitus (T2DM), and to analyze the correlation factors between dialysis and non-dialysis patients, so as to provide reference for clinical syndrome differentiation and treatment. METHODS: The general information, laboratory indicators, and TCM syndrome factors of CKD5 patients with T2DM were obtained upon admission. The participants were divided into non-dialysis and dialysis groups according to the treatment methods used. Multivariate logistic regression was used for analysis. The probability of planned dialysis in CKD5 patients with T2DM was calculated by combining multiple TCM syndrome factors, and a receiver operating characteristic curve was drawn. RESULTS: Approximately 77.2% of the study participants were men, with a median age of 59 years. A total of 277 and 95 patients comprised the non-dialysis and dialysis groups, respectively. The median duration of dialysis was 49.6 d. The dialysis group had a significantly higher serum creatinine level; a significantly lower estimated glomerular filtration rate, serum uric acid level, and 24-h urinary protein level; and a significantly lower proportion of patients with atherosclerosis (P < 0.01). The frequencies of Water stagnation pattern, Damp retention pattern, Heart deficiency pattern, and Lung deficiency pattern in the dialysis group were significantly higher (P < 0.01，P < 0.05), while the frequencies of Phlegm turbidity pattern and Kidney deficiency pattern were significantly lower (P < 0.01). Male sex [odds ratio (OR) = 1.780], Heart deficiency pattern (OR = 3.714), Yindeficiency pattern (OR = 2.262), and Water stagnation pattern (OR = 1.984) were factors related to planned dialysis in CKD5 patients with T2DM. The area under the receiver operating characteristic curve for planned dialysis in CKD5 patients with T2DM was 73.8% [95% confidence interval (0.680, 0.797), P < 0.001]. CONCLUSIONS: Male sex, Heart deficiency pattern, Yindeficiency pattern, and Water stagnation pattern were correlated with planned dialysis in CKD5 patients with T2DM. Kidney deficiency pattern and Phlegm turbidity pattern were correlated with CKD5 patients with T2DM who had not yet started planned dialysis. The study of TCM syndrome elements provides therapeutic ideas for relieving the uncomfortable symptoms of CKD 5 patients with T2DM, and provides reference for clinical syndrome differentiation and treatment.